A multi-centre randomized clinical trial is under way at 14 university dental schools in Germany to compare prosthodontic treatments for the shortened dental arch (SDA). One of the aims of this pilot-study was to measure the effect of two treatment options of the SDA on oral health-related quality of life and on the Research Diagnostic Criteria (RDC) for temporomandibular disorders (TMD). Thirty-four patients participated in the pilot-study. Inclusion criteria were: all molars were missing and the presence of at least both canines and one premolar in each quadrant. Participants were randomly assigned to receive either removable partial dentures including molar replacement (RPD_group) or retain a premolar occlusion (PROC_group). The Oral Health Impact Profile (OHIP-49) and the RDC for TMD were completed by participants before treatment (pre-treatment), 6 weeks (6 wks), 6 months (6m) and 12 months (12 m) after treatment. At the 12-month follow up, data of 10 women and 11 men (mean age: 62 +/- 10 years) were available. Medians of the OHIP total-scores were as follows: RPD (n = 10), 43.5 (pre-treatment), 18.2 (6 wks), 13.3 (6m), 14.7 (12 m). PROC (n = 11): 31.8 (pre-treatment), 27.1 (6 wks), 8.8 (6m), 8.3 (12 m). Significant differences were shown for RPD_group between pre-treatment and 6m/12 m and for PROC_group between pre-treatment and 6m. There were no significant differences between treatment groups at any time. Within each group, an improvement of life-quality was observed. No significant difference could be reported between the two therapy concepts. This may be due to the low sample size within the pilot study.
The objective of this study was to compare the shear bond strength to zirconium oxide ceramic of adhesive-phosphate-monomer-containing (APM) and non-APM-containing (nAPM) luting cements after different surface treatments. nAPM cements: Bifix QM, Dual Cement, Duo Cement Plus, Multilink Automix, ParaCem Universal DC, PermaCem Smartmix, RelyX ARC, Variolink Ultra, and Variolink II; APM cements: Panavia EX, Panavia F2.0, and RelyX UniCem. Groups of ten test specimens were each prepared by layering luting cement, using cylindrical Teflon molds, onto differently treated zirconium dioxide discs. The surface treatments were airborne-particle abrasion with 110 mum alumina particles, silica coating (SC) using 30 mum alumina particles modified by silica (Rocatec System) or SC and silanization. Bifix QM and Multilink Automix were used in combination with an additional bonding/priming agent recommended by the manufacturers. After 48 h of water storage, each specimen was subjected to a shear test. Combinations involving APM-containing cements (14.41-23.88 MPa) generally exhibited higher shear bond strength than those without APM (4.29-17.34 MPa). Exceptions were Bifix QM (14.20-25.11 MPa) and Multilink Automix (19.14-23.09 MPa) in combination with system-specific silane or priming agent, which were on the upper end of shear bond strength values. With the use of the Rocatec system, a partially significant increase in shear bond strength could be achieved in nAPM cement. Modified surface treatment modalities increased the bond strength to zirconium oxide, although the most important factor in achieving a strong bond was the selection of a suitable cement. System-specific priming or bonding agents lead to further improvement.
The aim of the study was to evaluate the influence of artificial aging on the fracture behavior of straight and angulated zirconia implant abutments (ZirDesign™; Astra Tech, Mölndal, Sweden) supporting anterior single crowns (SCs). Four different test groups (n = 8) representing anterior SCs were prepared. Groups 1 and 2 simulated a clinical situation with an ideal implant position (left central incisor) from a prosthetic point of view, which allows for the use of a straight, prefabricated zirconia abutment. Groups 3 and 4 simulated a situation with a compromised implant position, requiring an angulated (20°) abutment. OsseoSpeed™ implants (Astra Tech) 4.5 mm in diameter and 13 mm in length were used to support the abutments. The SCs (chromium cobalt alloy) were cemented with glass ionomer cement. Groups 2 and 4 were thermomechanically loaded (TCML = 1.2 × 10⁶; 10,000 × 5°/55°) and subjected to static loading until failure. Statistical analysis of force data at the fracture site was performed using nonparametric tests. All samples tested survived TCML. Artificial aging did not lead to a significant decrease in load-bearing capacity in either the groups with straight abutments or the groups with angulated abutments. The restorations that utilized angulated abutments exhibited higher fracture loads than the restorations with straight abutments (group 1, 280.25 ± 30.45 N; group 2, 268.88 ± 38.00 N; group 3, 355.00 ± 24.71 N; group 4, 320.71 ± 78.08 N). This difference in load-bearing performance between straight and angulated abutments was statistically significant (p = 0.000) only when no artificial aging was employed. The vast majority of the abutments fractured below the implant shoulder.
PURPOSEThe aim of this study was to evaluate the fracture resistance and fracture behavior of monolithic zirconia crowns in accordance with the preparation design and aging simulation method.MATERIALS AND METHODSAn upper first molar was prepared sequentially with three different preparation designs: shoulderless preparation, 0.4 mm chamfer and 0.8 mm chamfer preparation. For each preparation design, 30 monolithic zirconia crowns were fabricated. After cementation on Cr-Co alloy dies, the following artificial aging procedures were performed: (1) thermal cycling and mechanical loading (TCML): 5000 cycles of thermal cycling 5℃–55℃ and chewing simulation (1,200,000 cycles, 50 N); (2) Low Temperature Degradation simulation (LTD): autoclave treatment at 137℃, 2 bar for 3 hours and chewing simulation; and (3) no pre-treatment (control group). After artificial aging, the crowns were loaded until fracture.RESULTSThe mean values of fracture resistance varied between 3414 N (LTD; 0.8 mm chamfer preparation) and 5712 N (control group; shoulderless preparation). Two-way ANOVA analysis showed a significantly higher fracture loads for the shoulderless preparation, whereas no difference was found between the chamfer preparations. In contrast to TCML, after LTD simulation the fracture strength of monolithic zirconia crowns decreased significantly.CONCLUSIONThe monolithic crowns tested in this study showed generally high fracture load values. Preparation design and LTD simulation had a significant influence on the fracture strength of monolithic zirconia crowns.
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